保留NVB的前列腺癌根治术治疗前列腺癌的疗效  

Efficacy of radical prostatectomy with NVB preservation in the treatment of prostate cancer

作　　者：卢建伟 刘卫红 李攀科 LU Jianwei;LIU Weihong;LI Panke(Puyang County People’s Hospital,Puyang 457100,Henan)

机构地区：[1]濮阳县人民医院,河南濮阳457100

出　　处：《菏泽医学专科学校学报》2024年第2期16-19,49,共5页Journal of Heze Medical College

摘　　要：目的 分析保留神经血管束(NVB)的前列腺癌根治术治疗前列腺癌的效果及对尿动力学指标、术后尿失禁及近期预后的影响。方法 选择在我院行前列腺癌根治术的患者80例,将其中接受前列腺癌根治术治疗未保留NVB的38例患者作为对照组,接受前列腺癌根治术治疗保留NVB的42例患者作为观察组,比较两组患者的手术时间,术中出血量,尿管留置时间,切缘阳性率,国际前列腺症状评分(IPSS),尿动力学指标(最大尿流率、最大尿道闭合压、最大膀胱容量、残余尿量),术后并发症发生情况(尿失禁、切口感染、吻合口瘘、膀胱损伤)及近期预后情况(生化复发率)。结果 两组手术时间、术中出血量及尿管留置时间比较,P>0.05;观察组患者的切缘阳性率低于对照组(P<0.05);观察组患者的IPSS评分低于对照组(P<0.05);观察组患者的最大尿流率、最大尿道闭合压及最大膀胱容量均高于对照组,残余尿量低于对照组(P<0.05);观察组患者术后尿失禁及并发症发生率均低于对照组(P<0.05);观察组患者术后6个月内生化复发率低于对照组(P<0.05)。结论 保留NVB的前列腺癌根治术对前列腺癌的临床治疗效果较好,可有效改善患者临床症状、尿动力学与近期预后,减少术后尿失禁等并发症发生。Objective To analyze the curative effect of radical prostatectomy(RP)with neurovascular-bundle(NVB)preservation on prostate cancer(PCa)and its influence on urodynamics indexes,postoperative urinary incontinence and short-term prognosis.Methods A retrospective analysis was performed on the clinical data of 80 patients with PCa undergoing RP in the hospital.38 cases in control group were treated without NVB preservation and 42 cases in observation group were treated with NVB preservation.The operation time,intraoperative blood loss,catheter indwelling time,positive margin rate,international prostate symptom score(IPSS),urodynamics indices(maximum flow rate,maximum urethral closure pressure,maximum bladder volume,residual urine volume),occurrence of postoperative complications(urinary incontinence,incision infection,anastomotic fistula,bladder injury)and short-term prognosis(biochemical recurrence rate)in the two groups were compared.Results There was no significant difference in operation time,intraoperative blood loss and catheter indwelling time between the two groups(P>0.05).The positive margin rate in observation group was lower than that in control group(P<0.05);IPSS score was lower than that in control group(P<0.05).The maximum flow rate,maximum urethral closure pressure and maximum bladder volume in observation group were higher than those in control group,while residual urine volume was less than that in control group(P<0.05).The incidence of postoperative urinary incontinence and complications in observation group was lower than that in control group(P<0.05).Within 6 months after surgery,biochemical recurrence rate in the observation group was lower than that in control group(P<0.05).Conclusion The RP with NVB preservation is effective in the treatment of PCa,which can effectively improve clinical symptoms,urodynamics and short-term prognosis,reduce postoperative complications such as urinary incontinence,and have high safety.

关 键 词：前列腺癌 神经血管束 根治术 疗效 

分 类 号：R737.25[医药卫生—肿瘤]